Kay Mimaki, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY18375 Issued in CA

Practice address

3611 Motor Ave Ste 240
Los Angeles, CA 90034-5887

Phone

(310) 421-8171

NPI assigned

Feb 7, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kay Tanaka Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr. Kay Psychology Inc

  • Psychologist
  • Los Angeles, CA
  • NPI 1033938535
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1104966308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21213B HAWTHORNE BLVD",
            "address_2": "#1142",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90503",
            "telephone_number": "424-237-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 MOTOR AVE STE 240",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900345887",
            "telephone_number": "310-421-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMAKI",
        "first_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11569035",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAY",
            "last_name": "TANAKA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ann Milton, REGISTERED NURSE
• Nicole Lynette Milton, LVN
• Danielle Milus
• Andrea Milwidsky, MA
• Nonna Aleksandrovna Milyavskaya, AMFT
• Mimas Hospice and Palliative Care, Inc.
• Stephanie Yvette Mimbs
• Mimi Lee Medical Group Inc
• Courtney Alexandra Mims
• Ignatio Lionel Mims

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.